University of Waterloo

Permanent URI for this communityhttps://uwspace.uwaterloo.ca/handle/10012/1

This institution-wide community is designed to house collections of Waterloo created electronic research that span the institution or are not logically subsumed by a single faculty sub-community.

Browse

Browsing University of Waterloo by Author "Abdelrahman, Sara"

Filter results by typing the first few letters
Now showing 1 - 1 of 1
  • Thumbnail Image
    Item
    Governance and Public Engagement from the Perspectives of Antimicrobial Resistance Experts: An Explorative Study
    (University of Waterloo, 2025-04-29) Abdelrahman, Sara
    Background: Antimicrobial resistance (AMR) has long been a threat to medicine as it reduces the efficacy of antimicrobials that once saved millions of lives. AMR is a multifaceted issue that has many drivers and thus, multiple actors need to be involved for an effective solution. Current prescribing practices, non-compliance issues, and even climate change are accelerating the rate at which AMR is occurring, hence current and future plans need to focus on hindering its propagation. AMR is a One Health problem that involves many sectors and in essence a social issue that necessitates proper governance structures across sectors as well as effective public engagement. Objectives: The main objective of this study was to identify and compare governance and public engagement elements that emerged from Swedish and Malaysian AMR experts’ discussions during two workshops held on September and October 2020 on the effectiveness and sustainability of taxation and Infection Prevention Control measures in tackling AMR in the future. Specifically, the objectives of this study were to: (i) identify and compare governance elements emerging from Sweden and Malaysia, (ii) identify public engagement elements emerging from Sweden and Malaysia, and (iii) identify and compare context-specific governance and public engagement challenges and opportunities in both contexts. Methods: A secondary data analysis was conducted on pre-existing data collected from 18 AMR experts in Sweden and Malaysia that discussed taxation and infection prevention control measures as effective interventions to tackle AMR in 2030 and 2050. These data were analyzed for governance and public engagement elements using Anderson’s governance framework and the sociocognitive theory, respectively. NVivo software was used to analyze and organize the data based on the governance and public engagement frameworks selected; new elements of governance and public engagement that emerged were also added as necessary. Results: Swedish and Malaysian AMR experts discussed all 18 of Anderson's governance elements. Swedish and Malaysian AMR experts described governance as needing proper diagnostics, a One Health surveillance system, investment into research and development, lesson learning, and collaboration across industries and countries. Swedish AMR experts discussed all 6 elements of public engagement, whereas Malaysian experts discussed only four. Malaysian experts did not discuss ‘goals’ and ‘sociocultural facilitators.’ While Swedish AMR experts discussed people’s willingness to pay for antibiotic-free products and needing quick fixes, Malaysian AMR experts discussed the issue of wet markets in Southeast Asia. Context-specific opportunities and challenges differed across the two contexts. Two new elements of governance were identified through Swedish AMR experts’ discussions: incentivization of pharmaceutical companies to develop antimicrobials and raising AMR priority among policymakers. No new elements of governance were revealed through Malaysian experts’ discussions. Consistent messaging was a new element of public engagement revealed through Swedish AMR experts' discussions, while two new elements were revealed through Malaysian AMR experts: AMR message delivery and conflict of interest. Interactions were observed within governance elements, public engagement elements, and between the two frameworks. Conclusion: This study highlighted the multidisciplinary nature of a complex issue like AMR. It is the first to use Anderson’s governance framework to evaluate AMR discussions presented by experts from Sweden and Malaysia and employ the sociocognitive theory, which is often underrepresented in the AMR literature. The discovery of new elements of governance, public engagement, and the overall interactions between the two concepts shows that there is much yet to know about AMR and its driving factors.